Browsing Posts tagged Obamacare

One of the ironies of politics is that big government by its nature actually favors those who are more wealthy – thus big business loves big gov’t. A few months ago, I alluded in the comments that I suspect that one of the unintended consequences of the Affordable Healthcare Act (aka “Obamacare”) would be that the more affluent would simply opt out and start going to concierge medical services in which the doctor makes him/herself available to fewer customers at a higher price at any time they are called. It is all cash and they don’t deal with insurance at all. Read more about the concept here.

I’m usually not so much interested in the “problem” (in this case “Obamacare”) as I am in the solution. And here, the solution is to make more money and pay for concierge medicine! But seriously, I suspect that many businesses will likely see a money making opportunity and establish concierge medicine options for middle income brackets as well. I understand that this is already happening. As technology gets better, the solution is increasingly going to be to simply opt out of whatever it is the gov’t tries to provide (with a few obvious exceptions). Especially as more physicians completely avoid insurance companies and government based medical payment systems altogether.

As it all pans out over the years, it seems that health insurance as we now know it will be pretty much only for emergency care and catastrophes like major surgery and cancer treatment.

At the Ronald Reagan Lecture Series meeting on February 6, 2012, in Sterling, Virginia, Attorney General Ken Cuccinelli explains the commonwealth’s lawsuit against the federal government challenging the individual mandate of the Democrat health care legislation.

Interesting read in the WSJ about Medicare part D where the Dems want to change parts of Medicare part D (drug plan) to save us money. As always, anytime they say they are saving us money it ends up costing an arm and a leg. Take this proposal as example. Medicare part D was a Bush thing where it was handled thru market competition. Now this is one of the only times where an entitlement has ended up costing less than expected and worked better than advertised. You’ll also remember that Bush wanted to do something similar with Social Security (never a truer name) and the Dems raved how people would be in the streets homeless or dead because of it. We’ll never know now but it appears that when things are left to competition and the markets, we all end up winners.

Maybe it is time to review and move forward with the Ryan Plan if we ever want to save these entitlement programs. I would venture to say that it would be wise to use this mindset in the future when our government wants more people on their dole with your money. Worth the read. You’ll never see this article in AARP (All About Raping the Public).

by jacob
When it comes to health care the public option is not the only option. There are many other ways to cut costs in health care. Part of the equation is that lack of Health Insurance does not equal lack of Health Care. This equivocation is a lie that has been perpetrated on the American public. Hospitals are required to treat patients. While emergency rooms are an inefficient vector for delivering health care, government takeover is even more inefficient means of delivery.

There are many other ways of reducing costs. First of all reduce the price of the insurance. How? First, start by allowing competition across state lines. The trouble with health care is that there is already too much government control and spending in this sector of the economy. Any solution that increases public sector influence in this segment of the economy will only lead to greater cost. What is needed here instead is a freer market. People should be allowed to shop anywhere for their medical health insurance. If people can find their own car, home and life insurance — they are also capable of choosing/finding health insurance — preferably in a free market.

Part of the current trouble is that the Federal and State Governments have not allowed for a free market. Dictating that insurance companies include given services in health care contracts does not provide choice; it instead has the opposite effect. A healthy 25 year old does not need the same type of coverage as the middle aged. The insurance companies should be left to provide a wider range of services. An example of the this kind problem is that men in their 20′s are forced to buy into health care insurance packages that include gynecological services. Services that are targeted toward various demographics will allow consumer choice and will encourage greater participation.

The next part of the equation is the fact that we, as a people have frankly ridiculous expectations when it comes to health care. We all have car insurance. Do we expect Geico to pay for tune ups, new tires and oil changes? No. Of course not. If automobile insurance did pay for such maintenance then we would be paying $8K to $10K per year for our car insurance. We have home insurance, do we expect insurance to pay for home maintenance? If we could buy insurance that did not cover a check up or a “Johnny has the sniffles” sick visit we would see our health care premiums slashed by some 30% to 40%.

Then there is the tremendous cost to the public caused be medical malpractice law suites. There are three culprits in this issue. The doctors, the lawyers and the public at large.

The Medical profession has historically refused to truly police itself. When doctors in the past proved themselves to be incompetent or negligent, the medical board would typically close ranks and protect one of their own. This is white equivalent of the blue wall of silence. This in turn lead to the second problem — lawyers.

The second culprit are the trial lawyers cum ambulance chasers. When satisfaction could not be found due to the AMA’s intransigence, the law was the only recourse for the public at large. The trouble here is that this profession has also jumped the shark and now we have lawyers trolling for cases through the media with lines like “If you even THINK you MAY have been wronged …” Which plays on the weaknesses of the third party in this dance. The public.

Many people think they will get rich suing their doctor. This is typically false. Especially in class action lawsuits. The only people who make out in class action suits are the lawyers. The thousands who are represented get a token check. The medical insurance company pays out millions. The lawyers get rich. The people paying for health insurance get stuck with the bill. Tort reform should concentrate on this issue first and foremost.

The end result is where we are today — doctors paying medical malpractice insurance premiums to the tune of $150K-$250K per year, per doctor. That is a burden of some $45B to $75B per year just to service malpractice insurance premiums. A burden that is passed on to the public at large. This does not include the costs of defensive medicine, whose impact on the price of medicine is even larger, and even harder to determine.

A possible solution is one where doctors who are repeatedly found negligent would see their licenses revoked. This would benefit the public on two fronts. First of all the medical profession would improve. Secondly, if the bottom 10% of the profession is gone, or improving then the number of lawsuits would drop. As the profession becomes a better risk, then the price of medical services will drop because the overhead from malpractice insurance will drop.

Health Care and Health Care Insurance are not the same thing. Emergency rooms are unfortunately the most expensive means of delivering medical treatment. An alternative are Health Care clinics with extended hours for the uninsured to handle sniffles, ear infections, or some minor trauma. Such clinics could deliver quality health care at a price that is far less than than sending people to the emergency room. Out of pocket expenses could be kept further down as the paperwork caused by insurance is out of the picture. People spend $75 for a plumber, or $30 for an oil change. Why is it too much to expect someone to pay $50 to $100 for the treatment of a simple medical problem?

For more complex issues, such as the uninsured with cancer, the current solution has its troubles, but the government single payer solution is worse. If the insurance industry were allow to provide plans that target catastrophic issues only, such plans would cost far less than the ‘Cadillac’ plans typically provided today. The numbers of the uninsured would certainly drop because cheaper is more accessible.

More than likely some will not be covered. No solution will bring us to Utopia. The trouble with the 3000 page mess we are being threatened with is that Utopia would not even be on the horizon. Currently we have some 10M to 30M who are not covered today. We can reduce this number by reducing the price of insurance with greater market based choices. A medical profession that vigorously polices itself, coupled with some sort of tort reform, will reduce the price of insurance further. The alternative proposed by the left is the government taking control over what should be our own personal business.